Using Coronary Artery Calcium Score as Diagnostic Tool in Symptomatic Chronic Coronary Syndrome Patients in a Real-Life Setting

Figures & data

Table 1 Patient Characteristics Study Population

	n = 882
Male, n (%)	248 (28.1)
Age (years), mean (SD)	53.5 (± 10.2)
Age < 40 years, n (%)	79 (9.0)
Age 40–50 years, n (%)	221 (25.1)
Age 50–60 years, n (%)	331 (37.5)
Age 60–70 years, n (%)	208 (23.6)
Age ≥ 70 years, n (%)	43 (4.9)
Hypertension, n (%)	269 (30.6)
Hypercholesterolemia, n (%)	204 (25.4)
Diabetes mellitus, n (%)	52 (5.9)
Current smoker, n (%)	162 (18.9)
Family history (premature) CVD, n (%)	299 (37.0)

Abbreviations: n, number; SD, standard deviation; CVD, cardiovascular disease.

Figure 1 Distribution of CAC score per clinical symptom category based on the 2019 ESC guideline on chronic coronary syndromes: non-anginal chest pain, atypical angina, typical angina or dyspnea.

Figure 2 Distribution of CAC scores across PTP for CAD categories.

Table 2 Characteristics of Patients with CAC Score of 0 and CAC Score > 0

	CAC Score = 0 (n = 440)	CAC Score > 0 (n = 347)	p value
Male, n (%)	108 (24.5)	110 (31.7)	0.026*
Age (years), mean (SD)	50.0 (± 9.5)	57.8 (± 9.5)	<0.0001*
Hypertension, n (%)	93 (21.1)	142 (40.9)	<0.0001*
Hypercholesterolemia, n (%)	76 (17.3)	110 (31.7)	<0.0001*
Diabetes, n (%)	19 (4.3)	31 (8.9)	0.008*
Current smoker, n (%)	79 (18.0)	65 (18.7)	0.78
Family history (premature) CVD, n (%)	150 (34.1)	140 (40.3)	0.071

Note: *Indicates significant difference.

Abbreviations: CAC, coronary artery calcium; n, number; SD, standard deviation; CVD, cardiovascular disease.

Table 3 Association Between Number of Risk Factors and Elevated CAC Score (CAC Score > 0)

Number of Risk Factors	N total/CAC > 0	OR (95% CI)	p value
All Patients
No risk factors	238/71	1	–
1 risk factor	285/126	1.86 (1.29–2.68)	<0.001*
2 risk factors	184/98	2.67 (1.79–4.01)	<0.0001*
≥ 3 risk factors	80/52	4.34 (2.55–7.51)	<0.0001*
Patients with low PTP
No risk factors	110/14	1	–
1 risk factor	141/43	2.98 (1.56–5.99)	<0.001*
2 risk factors	82/29	3.71 (1.82–7.85)	<0.001*
≥ 3 risk factors	35/19	7.94 (3.36–19.57)	<0.0001*
Patients with intermediate PTP
No risk factors	106/40	1	–
1 risk factor	115/61	1.86 (1.09–3.20)	0.023*
2 risk factors	82/50	2.56 (1.42–4.68)	0.002*
≥ 3 risk factors	32/22	3.57 (1.56–8.69)	0.002*
Patients with high PTP
No risk factors	22/17	1	–
1 risk factor	29/22	0.93 (0.23–3.53)	0.92
2 risk factors	20/19	4.91 (0.66–139.3)	0.13
≥ 3 risk factors	13/11	1.54 (0.26–13.69)	0.64

Notes: Risk factors were hypertension, hypercholesterolemia, diabetes mellitus, current smoking status and family history of (premature) CVD. All data were obtained from hospital medical records. Hypertension, hypercholesterolemia and diabetes mellitus were diagnosed by the treating physician. *Indicates significant difference.

Abbreviations: CAC, coronary artery calcium; N, number; OR, odds ratio; 95% CI, 95% confidence interval; PTP, pre-test probability.

Figure 3 Results of CAC scores compared to results of exercise ECG. For each exercise ECG result (normal, abnormal, inconclusive) we showed the distribution of CAC scores.

Figure 4 Results of coronary angiography compared with results of CAC score. For each CAC score result (CAC score = 1–99, CAC score = 100–399, CAC score ≥ 400) the distribution of results of coronary angiography is shown.

Figure 5 Results of coronary angiography compared with results of exercise ECG. For each exercise ECG result (normal, abnormal, inconclusive) the distribution of results of coronary angiography is shown.